COVER Act

II 116TH CONGRESS 2D SESSION S. 4557 To support efforts to provide intensive, individualized assistance for enrolling in health care coverage. IN THE SENATE OF THE UNITED STATES SEPTEMBER 10, 2020 Ms. BALDWIN (for herself, Mr. BOOKER, Ms. SMITH, Ms. CORTEZ MASTO, Ms. HIRONO, Mr. MERKLEY, Mr. BLUMENTHAL, and Ms. ROSEN) intro- duced the following bill; which was read twice and referred to the Com- mittee on Health, Education, Labor, and Pensions A BILL To support efforts to provide intensive, individualized assistance for enrolling in health care coverage. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘COVid Enrollment Re- 4 sponse Act’’ or the ‘‘COVER Act’’. 5 SEC. 2. INTENSIVE, INDIVIDUALIZED ASSISTANCE FOR EN- 6 ROLLING IN HEALTH CARE. 7 Section 1311(i)(6) of the Patient Protection and Af- 8 fordable Care Act (42 U.S.C. 18031(i)(6)) is amended— 9 VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 4557 IS (1) by striking ‘‘Grants under this subsection 1 shall be made from’’ and inserting the following: 2 ‘‘(A) IN GENERAL.—Grants under this 3 subsection shall be made from funds appro- 4 priated under subparagraph (B) and’’; and 5 (2) by adding at the end thereof the following: 6 ‘‘(B) APPROPRIATION.— 7 ‘‘(i) AMOUNT.—Out of any funds in 8 the Treasury not otherwise appropriated, 9 there are hereby appropriated, to carry out 10 this subsection, $150,000,000 for fiscal 11 year 2020, and $600,000,000 for fiscal 12 year 2021. 13 ‘‘(ii) ALLOTMENTS.— 14 ‘‘(I) IN GENERAL.—Payments of 15 allotments under this subparagraph 16 shall be made as soon as possible and 17 remain available until expended. 18 ‘‘(II) NUMBER OF UNINSURED.— 19 Fifty percent of the funds appro- 20 priated under this subparagraph for a 21 fiscal year shall be expended in annual 22 allotments for a State and the District 23 of Columbia in proportion to the num- 24 ber of uninsured individuals in such 25 VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 4557 IS State or District during calendar year 1 2018, as demonstrated by American 2 Community Survey State-level data. 3 ‘‘(III) RECIPIENTS OF UNEM- 4 PLOYMENT INSURANCE.—Fifty per- 5 cent of the funds appropriated under 6 this subparagraph for a fiscal year 7 shall be expended in quarterly allot- 8 ments for a State and the District of 9 Columbia in proportion to the average 10 number of recipients of unemployment 11 insurance in the State or Districts, in- 12 cluding all categories of assistance, 13 during the most recent calendar quar- 14 ter for which data are available from 15 the Department of Labor. 16 ‘‘(iii) USE.—Notwithstanding any 17 other provision of this subsection, funds 18 described in this subparagraph shall be— 19 ‘‘(I) used at any point during the 20 calendar year to facilitate enrolling in- 21 dividuals into and maintaining indi- 22 viduals’ coverage in State Medicaid 23 plans under title XIX of the Social 24 Security Act, State Children’s Health 25 VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 4557 IS Insurance Programs under title XXI 1 of such Act, qualified health plans, 2 COBRA continuation coverage, group 3 health plans offered to furloughed em- 4 ployees on the same terms they are of- 5 fered to other employees, and other 6 health coverage programs sponsored 7 by States and localities, with coun- 8 seling and assistance provided by enti- 9 ties that assume a fiduciary duty to 10 act in such individuals’ best interests; 11 ‘‘(II) used to develop relation- 12 ships with State workforce agencies 13 (and, at the entity’s option, employ- 14 ers) through which an entity funded 15 through this subparagraph reaches 16 out to individuals losing employment 17 and helps them enroll into minimum 18 essential coverage; 19 ‘‘(III) awarded to organizations 20 (which may include agencies of States 21 or political subdivision using hired or 22 rehired employees) with a dem- 23 onstrated capacity to perform the du- 24 ties specified in paragraph (3) (ex- 25 VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 4557 IS tended, for purposes of this subpara- 1 graph, to include all programs de- 2 scribed in subclause (I)) and this sub- 3 paragraph, including relationships 4 with and experience in successfully 5 serving laid-off and furloughed work- 6 ers, residents of rural areas and com- 7 munities of color, low-income individ- 8 uals, members of immigrant families, 9 and other historically underserved 10 populations; 11 ‘‘(IV) awarded to organizations, 12 within each State, that include at 13 least two organizations located in the 14 State serviced by such organizations, 15 at least one of which is a community- 16 based and consumer-oriented non- 17 profit group; and 18 ‘‘(V) used to supplement rather 19 than supplant other funding, staffing, 20 and programming provided under this 21 subsection. 22 ‘‘(iv) DEFINITION.—For purposes of 23 this subparagraph, the term ‘COBRA con- 24 tinuation coverage’ means continuation 25 VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 4557 IS coverage provided pursuant to part 6 of 1 subtitle B of title I of the Employee Re- 2 tirement Income Security Act of 1974 3 (other than under section 609), title XXII 4 of the Public Health Service Act, section 5 4980B of the Internal Revenue Code of 6 1986 (other than subsection (f)(1) of such 7 section insofar as it relates to pediatric 8 vaccines), or section 8905a of title 5, 9 United States Code, or under a State pro- 10 gram that provides comparable continu- 11 ation coverage. Such term does not include 12 coverage under a health flexible spending 13 arrangement under a cafeteria plan within 14 the meaning of section 125 of the Internal 15 Revenue Code of 1986.’’. 16 Æ VerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S4557.IS S4557 pamtmann on DSKBC07HB2PROD with BILLS